title: Adolescent use of school-based health centers and high school dropout.
abstract: OBJECTIVE
  To determine the association between use of school-based health centers (SBHCs) and school dropout.
  
  
  METHODS
  Quasi-experimental longitudinal analysis of a retrospective student cohort, with SBHC use as the independent variable. We statistically controlled for dropout risk and used propensity score regression adjustment to control for several factors associated with SBHC use.
  
  
  METHODS
  Integrated database from an urban public school district (academic outcomes) and department of public health (SBHC use).
  
  
  METHODS
  District-enrolled students in their first semester of ninth grade in 2005 (N = 3334), followed up through their anticipated on-time graduation semester of 12th grade in 2009. Students were divided into 4 groups: never used (47%); low use (23%); moderate use (20%); and high users (10%).
  
  
  METHODS
  Time to nongraduation (described as dropout).
  
  
  RESULTS
  Low to moderate SBHC use (0.125-2.5 visits per semester) was associated with a 33% reduction in dropout compared with non-SBHC users. The high-use group (>2.5 visits per semester) did not have dropout rates that differed from nonusers. For SBHC users who did drop out, dropout occurred approximately 1 semester later than nonusers. Exploratory analyses revealed that the association between SBHC use and prevention of dropout was greatest for higher-risk students.
  
  
  CONCLUSIONS
  This study found an association between low to moderate SBHC use and reductions in dropout for high school students in an urban school district, especially for students at higher risk for dropout. This study supports the theory that benefits of SBHCs extend beyond managing physical and mental health needs to include academic outcomes.
authors.affiliation: Division of Public Behavioral Health and Justice Policy, 2815 Eastlake Ave E, Ste 200, Seattle, WA 98102, USA. sekerns@uw.edu
authors.forename: Suzanne E U
authors.initials: SE
authors.lastname: Kerns
authors.forename: Michael D
authors.initials: MD
authors.lastname: Pullmann
authors.forename: Sarah Cusworth
authors.initials: SC
authors.lastname: Walker
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Lyon
authors.forename: T J
authors.initials: TJ
authors.lastname: Cosgrove
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Bruns
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012572:School Health Services / Q000706:statistics & numerical data*; D013332:Student Dropouts / Q000706:statistics & numerical data*; D014505:Urban Population